Late sequelae of pulmonary tuberculosis treated by thoracoplasty

With the help of information provided by the Office of Population, Censuses and Surveys the survival up to 1 July 1985 of the 171 patients treated for pulmonary tuberculosis by thoracoplasty at Papworth from 1951 to 1953 was determined. Thirteen (8%) could not be traced, 65 (38%) had died, and 93 (54%) were alive. For those who were traced the survival at 10, 20, and 30 years from the date of operation was 93%, 79%, and 65%. This represents a significantly greater mortality rate than that predicted from the Registrar General's review of deaths in England and Wales (1841-1984). Nineteen patients died from cardiorespiratory failure. Eight of the survivors are known to have developed respiratory failure, five having enjoyed apparently good health before this was precipitated by intercurrent illness or drugs. A stepwise logistic regression analysis using information from the 124 patients for whom full details were available showed significant associations between the development of cardiorespiratory or respiratory failure and a preoperative contralateral artificial pneumothorax, older age at operation, the presence of cavities before operation, and male sex. In a questionnaire 50 of the survivors (57% of those who replied) reported cough, 45 (51%) breathlessness, 41 (47%) wheeze, and 24 (27%) ankle swelling. Nineteen (22%) smoke and the same number now attend a chest clinic. Many patients treated for tuberculosis by thoracoplasty have respiratory symptoms and some are at risk of respiratory failure. There are grounds for considering that they should be reviewed periodically by a chest physician.